US20250295425A1 - Apparatus for endoscopic procedures - Google Patents

Abstract

An electromechanical surgical system having an instrument housing for connecting with a shaft assembly, a shaft assembly, and an end effector. The end effector is an articulating end effector and the system includes a cable tensioning system for tensioning the articulation cables. The system includes a clutch mechanism for preventing slippage of a drive cable. The electromechanical system includes a staple cartridge that includes a knife that is movable between a raised position and a lowered position.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• This application is a continuation claiming the benefit of and priority to U.S. patent application Ser. No. 18/210,400, filed Jun. 15, 2023, which is a continuation claiming the benefit of and priority to U.S. patent application Ser. No. 17/984,525, filed Nov. 10, 2022, (now U.S. Pat. No. 12,035,933), which is a continuation claiming the benefit of and priority to U.S. patent application Ser. No. 17/544,554, filed Dec. 7, 2021, (now U.S. Pat. No. 11,497,517), which is a continuation claiming the benefit of and priority to U.S. patent application Ser. No. 16/738,076, filed Jan. 9, 2020, (now U.S. Pat. No. 11,207,089), which is a continuation claiming the benefit of and priority to U.S. patent application Ser. No. 15/294,813, filed on Oct. 17, 2016, (now U.S. Pat. No. 10,568,651), which is a divisional claiming the benefit of and priority to U.S. patent application Ser. No. 13/891,288, filed on May 10, 2013 (now U.S. Pat. No. 9,492,146), which is a continuation-in-part claiming the benefit of and priority to U.S. patent application Ser. No. 13/444,228, filed on Apr. 11, 2012 (now U.S. Pat. No. 8,672,206), which is a continuation-in-part claiming the benefit of and priority to each of U.S. patent application Ser. No. 13/280,898, filed on Oct. 25, 2011 (now U.S. Pat. No. 8,899,462) and U.S. patent application Ser. No. 13/280,859, filed on Oct. 25, 2011 (U.S. Pat. No. 8,657,177), the entire contents of each of which are incorporated by reference herein.
• U.S. patent application Ser. No. 13/891,288, filed on May 10, 2013 (now U.S. Pat. No. 9,492,146), also claims the benefit of and priority to each of U.S. Provisional Patent Application No. 61/779,873, filed on Mar. 13, 2013, U.S. Provisional patent application Ser. No. 61/672,891, filed on Jul. 18, 2012, and U.S. Provisional Patent Application 61/659,116, filed on Jun. 13, 2012, the entire contents of each of which are incorporated by reference herein.
BACKGROUND1. Technical Field
• The present disclosure relates to surgical apparatus, devices and/or systems for performing endoscopic surgical procedures and methods of use thereof. More specifically, the present disclosure relates to electromechanical, hand-held surgical apparatus, devices and/or systems configured for use with removable disposable loading units and/or single use loading units for clamping, cutting and/or stapling tissue.
2. Background of Related Art
• A number of surgical device manufacturers have developed product lines with proprietary drive systems for operating and/or manipulating electromechanical surgical devices. Some electromechanical surgical devices include a handle assembly, which is reusable, and replaceable loading units and/or single use loading units or the like that are selectively connected to the handle assembly prior to use and then disconnected from the handle assembly following use, in order to be disposed of or in some instances sterilized for re-use.
• Many of these electromechanical surgical devices are relatively expensive to manufacture, purchase and/or operate. There is a desire by manufactures and end users to develop electromechanical surgical devices that are relatively inexpensive to manufacture, purchase and/or operate.
• Accordingly, a need exists for electromechanical surgical apparatus, devices and/or systems that are relatively economical to develop and manufacture, to store and ship, as well as economical and convenient to purchase and use from the end user's perspective.
SUMMARY
• According to an aspect of the present disclosure, an electromechanical surgical system comprises an instrument housing defining a connecting portion for selectively connecting with a shaft assembly, and having at least one rotatable drive member. An end effector is configured to perform at least one function, and the shaft assembly is arranged for selectively interconnecting the end effector and the instrument housing, the shaft assembly including at least one rotatable drive member and at least one link for allowing articulation of the end effector. First and second diametrically opposed articulation cables extend at least partially along the at least one link. Each articulation cable includes a distal end anchored to the at least one link, and a proximal end being secured to a respective first and second axially displaceable rack, each rack being operatively connected to one another by a spur gear. The spur gear is attached to a clevis. The system includes a cable tensioning assembly attached to the spur gear and including a screw and a biasing member between the screw and the clevis, and a clutch mechanism attached to at least one of the at least one drive member of the shaft assembly.
• In certain embodiments, the shaft assembly further includes: a threaded rod extending proximally from the first rack; and wherein rotation of the at least one drive member of the shaft assembly imparts rotation to the threaded rod and to move the first rack and articulate the end effector. The shaft assembly may further include: a distal neck housing supported at a distal end of the at least one link, a first articulation cable including a distal end secured to the at least one link and a proximal end secured to the first rack; and a second articulation cable including a distal end secured to the at least one link and a proximal end secured to the second rack, the first and second articulation cables diametrically opposed to one another.
• Rotation of threaded rod may translate the first rack to axially displace the first articulation cable to articulate the end effector. The clevis can be axially slidable and rotatably supporting the spur gear. Axial displacement of the clevis can result in axial displacement of the spur gear and, in turn, the first rack and the second rack.
• The clevis is desirably biased in a proximal direction. The clevis is connected to the screw to axially displace the clevis upon a rotation of the adjustment screw. The clutch mechanism can have a plunger member with camming surfaces and a coupling member with camming surfaces. In certain embodiments, the clutch mechanism includes a biasing member engaged with the plunger member to press the plunger member against the coupling member so that the camming surfaces of the plunger member are in engagement with the camming surfaces of the coupling member.
• In certain embodiments, the clutch mechanism includes a coupler defining an angled inner-annular surface for mating with an angled outer annular profile of the plunger member.
• In a further aspect of the present disclosure, an electromechanical surgical system comprises an instrument housing defining a connecting portion for selectively connecting with a shaft assembly, the surgical instrument having at least one rotatable drive member, an end effector configured to perform at least one function and having a rotation hub, and the shaft assembly is arranged for selectively interconnecting the end effector and the instrument housing, the shaft assembly including at least one drive member, the at least one drive member of the shaft assembly being connectable to the rotation hub when the shaft assembly is connected to the end effector. The shaft assembly has a clutch mechanism attached to at least one of the at least one drive member of the shaft assembly.
• The clutch mechanism may have a plunger member with camming surfaces and a coupling member with camming surfaces. The clutch mechanism, in certain embodiments, includes a biasing member engaged with the plunger member to press the plunger member against the coupling member so that the camming surfaces of the plunger member are in engagement with the camming surfaces of the coupling member.
• Further details and aspects of exemplary embodiments of the present invention are described in more detail below with reference to the appended figures.
BRIEF DESCRIPTION OF THE DRAWINGS
• Embodiments of the present disclosure are described herein with reference to the accompanying drawings, wherein:
• FIG.1 is a perspective view of an electromechanical surgical system according to an embodiment of the present disclosure;
• FIG.2 is a perspective view, with parts separated, of the electromechanical surgical system ofFIG.1;
• FIG.3 is a rear, perspective view of a shaft assembly and a powered surgical instrument, of the electromechanical surgical system ofFIGS.1 and2, illustrating a connection therebetween;
• FIG.4 is a perspective view, with parts separated, of the shaft assembly ofFIGS.1-3;
• FIG.5 is a perspective view, with parts separated of a transmission housing of the shaft assembly;
• FIG.6 is a perspective view of a first gear train system that is supported in the transmission housing;
• FIG.7 is a perspective view of a second gear train system that is supported in the transmission housing;
• FIG.8 is a perspective view of a third drive shaft that is supported in the transmission housing;
• FIG.9 is a perspective view of a neck assembly of the shaft assembly, shown in a straight orientation;
• FIG.10 is a perspective view of the neck assembly ofFIG.9, shown in an articulated condition;
• FIG.11 is a perspective view of the neck assembly ofFIGS.9 and10, with a threaded nut separated therefrom;
• FIG.12 is a perspective view, with parts separated, of the neck assembly ofFIGS.9-11;
• FIG.13 is a cross-sectional view of the neck assembly ofFIGS.9-12, as taken through13-13 ofFIG.9;
• FIG.14 is a cross-sectional view of the neck assembly ofFIGS.9-12, as taken through14-14 ofFIG.10;
• FIG.15 is a cross-sectional view of the neck assembly ofFIGS.9-12, as taken through15-15 ofFIG.14;
• FIG.16 is an illustration of the neck assembly ofFIG.13, shown in an articulated condition;
• FIG.17 is a perspective view of an articulation assembly;
• FIG.18 is a further perspective view of the articulation assembly ofFIG.17;
• FIG.19 is a perspective view of a second gear train that is supported in a distal neck housing of the neck assembly;
• FIG.20 is a perspective view, with parts partially separated, of a first gear train and the second gear train that are supported in a distal neck housing of the neck assembly;
• FIG.21 is a perspective view, with parts partially separated, of the first gear train and the second gear train that are supported in a distal neck housing of the neck assembly;
• FIG.22 is a cross-sectional view of the distal neck housing, as taken through22-22 ofFIG.19;
• FIG.23 is a cross-sectional view of the distal neck housing, as taken through23-23 ofFIG.22;
• FIG.24 is a cross-sectional view of the distal neck housing, as taken through24-24 ofFIG.22;
• FIG.25 is a cross-sectional view of the distal neck housing, as taken through25-25 ofFIG.22;
• FIG.26 is a rear, perspective view of the shaft assembly and an end effector, of the electromechanical surgical system ofFIGS.1 and2, illustrating a connection therebetween;
• FIG.27 is a perspective view of the end effector, shown in a closed condition;
• FIG.28 is a perspective view, with parts separated, of the end effector ofFIG.27;
• FIG.29 is a perspective view of a lower jaw of the end effector ofFIGS.27 and
• 28;
• FIG.30 is a perspective view of a drive beam, a knife sled and an actuation sled of the end effector ofFIGS.27-29;
• FIG.31 is a further perspective view of the drive beam, the knife sled and the actuation sled of the end effector ofFIGS.27-29;
• FIG.32 is a cross-sectional view as taken through32-32 ofFIG.31;
• FIG.33 is a perspective view, with parts separated, of the drive beam, the knife sled and the actuation sled of the end effector ofFIGS.27-29;
• FIG.34 is a cross-sectional view of the end effector ofFIG.27, as taken through34-34 ofFIG.27, illustrating the drive beam, the knife sled and the actuation sled in a proximal-most position;
• FIG.35 is an enlarged view of the indicated area of detail ofFIG.34;
• FIG.36 is a cross-sectional view of the end effector ofFIG.27, as taken through36-36 ofFIG.34;
• FIG.37 is an enlarged view of the indicated area of detail ofFIG.36;
• FIG.38 is a further enlarged view illustrating the drive beam, the knife sled and the actuation sled in a distally advanced position;
• FIG.39 is a cross-sectional view of the end effector ofFIG.27, as taken through34-34 ofFIG.27, illustrating the drive beam, the knife sled and the actuation sled in a distal-most position;
• FIG.40 is an enlarged view of the indicated area of detail ofFIG.39;
• FIG.41 is a cross-sectional view of a distal end of the end effector ofFIG.27, as taken through34-34 ofFIG.27, illustrating the actuation sled in a distal-most position;
• FIG.42 is a cross-sectional view of a proximal end of the end effector ofFIG.27, as taken through34-34 ofFIG.27, illustrating the drive beam and the knife sled in a proximal position;
• FIG.43 is a cross-sectional view of a proximal end of the end effector ofFIG.27, as taken through34-34 ofFIG.27, illustrating the drive beam and the knife sled in a proximal-most position;
• FIG.44 is a perspective view, with parts partially separated, of a release assembly supported in a distal end of a cartridge assembly of the end effector;
• FIG.45 is a perspective view, with parts separated, of the release assembly ofFIG.44;
• FIG.46 is a plan view of the release assembly ofFIGS.44 and45, shown in an unactuated condition;
• FIG.47 is a plan view of the release assembly ofFIGS.44 and45, shown in an actuated condition;
• FIG.48 is a plan view of a release assembly supported in a distal end of an upper jaw of the end effector, illustrated in an unactuated condition;
• FIG.49 is a plan view of the release assembly ofFIG.48, illustrated in an actuated condition;
• FIG.50 is a perspective view of a proximal portion of a neck assembly of the shaft assembly, according to another embodiment of the present disclosure;
• FIG.51 is another perspective view of the proximal portion of the neck assembly of the shaft assembly ofFIG.50;
• FIG.52 is a top, plan view of the proximal portion of the neck assembly ofFIGS.50 and51;
• FIG.53 is a side, elevational view of the proximal portion of the neck assembly ofFIGS.50 and51;
• FIG.54 is a bottom, plan view of the proximal portion of the neck assembly ofFIGS.50 and51;
• FIG.55 is a perspective view, with parts separated, of the proximal portion of the neck assembly ofFIGS.50 and51;
• FIG.56 is a perspective view of a cable tensioning assembly of the neck assembly ofFIGS.50 and51;
• FIG.57 is a perspective view of a clutch assembly of the neck assembly ofFIGS.50 and51;
• FIG.58 is an enlarged view of the indicated area of detail ofFIG.57;
• FIG.59 is an end view of the proximal portion of the neck assembly ofFIGS.50 and51, as seen from59-59 ofFIG.53;
• FIG.60 is an end view of the proximal portion of the neck assembly ofFIGS.50 and51, as seen from60-60 ofFIG.53;
• FIG.61 is a cross-sectional view of the proximal portion of the neck assembly ofFIGS.50 and51, as taken through61-61 ofFIG.53;
• FIG.62 is a cross-sectional view of the proximal portion of the neck assembly ofFIGS.50 and51, as taken through62-62 ofFIG.53;
• FIG.63 is a cross-sectional view of the proximal portion of the neck assembly ofFIGS.50 and51, as taken through63-63 ofFIG.59;
• FIG.64 is a cross-sectional view of the proximal portion of the neck assembly ofFIGS.50 and51, as taken through64-64 ofFIG.59;
• FIG.65 is a cross-sectional view of the proximal portion of the neck assembly ofFIGS.50 and51, as taken through65-65 ofFIG.59;
• FIG.66 is the cross-sectional view ofFIG.65, showing another position;
• FIG.67 is a side cross-sectional view of an alternate version of the actuation sled and knife blade assembly with the knife blade in a lowered position;
• FIG.68 is a cross-sectional view taken through a proximal portion of the end effector of the surgical instrument shown inFIG.1 with the knife blade in the lowered position;
• FIG.69 is a side cross-sectional view of an alternate version of the actuation sled and knife blade assembly with the knife blade in a raised position; and
• FIG.70 is a cross-sectional view taken through a proximal portion of the end effector of the surgical instrument shown inFIG.1 with the knife blade in the raised position.
DETAILED DESCRIPTION OF EMBODIMENTS
• Embodiments of the presently disclosed electromechanical surgical system, apparatus and/or device are described in detail with reference to the drawings, in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein the term “distal” refers to that portion of the electromechanical surgical system, apparatus and/or device, or component thereof, that are farther from the user, while the term “proximal” refers to that portion of the electromechanical surgical system, apparatus and/or device, or component thereof, that are closer to the user.
• Referring initially toFIGS.1-3, an electromechanical, hand-held, powered surgical system, in accordance with an embodiment of the present disclosure is shown and generally designated10. Electromechanical surgical system10 includes a surgical apparatus or device in the form of an electromechanical, hand-held, powered surgical instrument100 that is configured for selective attachment thereto of a plurality of different end effectors400, via a shaft assembly200, that are each configured for actuation and manipulation by the electromechanical, hand-held, powered surgical instrument100. In particular, surgical instrument100 is configured for selective connection with shaft assembly200, and, in turn, shaft assembly200 is configured for selective connection with any one of a plurality of different end effectors400.
• Reference may be made to International Application No. PCT/US2008/077249, filed Sep. 22, 2008 (Inter. Pub. No. WO 2009/039506) and U.S. patent application Ser. No. 12/622,827, filed on Nov. 20, 2009 (U.S. Patent Publication No. 2011-0121049), the entire content of each of which are hereby incorporated herein by reference, for a detailed description of the construction and operation of exemplary electromechanical, hand-held, powered surgical instrument100
• Generally, as illustrated inFIGS.1-3, surgical instrument100 includes an instrument housing102 having a lower housing portion104, an intermediate housing portion106 extending from and/or supported on lower housing portion104, and an upper housing portion108 extending from and/or supported on intermediate housing portion106. The surgical instrument100 has a controller for controlling certain functions of the surgical system, collecting data, and performing other functions. Instrument housing102 defines a cavity therein in which a circuit board (not shown) and a drive mechanism (not shown) are situated.
• The circuit board is configured to control the various operations of surgical instrument100, as will be set forth in additional detail below. In accordance with the present disclosure, instrument housing102 provides a housing in which a rechargeable battery (not shown), is removably situated. The battery is configured to supply power to any of the electrical components of surgical instrument100.
• Upper housing portion108 of instrument housing102 defines a nose or connecting portion108aconfigured to accept a corresponding shaft coupling assembly214 of transmission housing212 of shaft assembly200. As seen inFIG.3, connecting portion108aof upper housing portion108 of surgical instrument100 has a cylindrical recess108bthat receives shaft coupling assembly214 of transmission housing212 of shaft assembly200 when shaft assembly200 is mated to surgical instrument100. The connecting portion108aof the surgical instrument100 has at least one rotatable drive member. In particular, connecting portion108ahouses three rotatable drive members or connectors118,120,122, each independently actuatable and rotatable by the drive mechanism (not shown) housed within instrument housing102.
• Upper housing portion108 of instrument housing102 provides a housing in which the drive mechanism (not shown) is situated. The drive mechanism is configured to drive shafts and/or gear components in order to perform the various operations of surgical instrument100. In particular, the drive mechanism is configured to drive shafts and/or gear components in order to selectively move end effector400 relative to shaft assembly200; to rotate anvil assembly200 and/or end effector400, about a longitudinal axis “X” (seeFIGS.1 and2), relative to instrument housing102; to move an upper jaw or anvil assembly442 of end effector400 relative to a lower jaw or cartridge assembly432 of end effector400; to articulate and/or rotate the shaft assembly; and/or to fire a stapling and cutting cartridge within cartridge assembly432 of end effector400.
• The shaft assembly200 has a force transmitting assembly for interconnecting the at least one drive member of the surgical instrument to at least one rotation receiving member of the end effector. The force transmitting assembly has a first end that is connectable to the at least one rotatable drive member and a second end that is connectable to the at least one rotation receiving member of the end effector. When shaft assembly200 is mated to surgical instrument100, each of rotatable drive members or connectors118,120,122 of surgical instrument100 couples with a corresponding rotatable connector sleeve218,220,222 of shaft assembly200 (seeFIGS.3 and5). In this regard, the interface between corresponding first drive member or connector118 and first connector sleeve218, the interface between corresponding second drive member or connector120 and second connector sleeve220, and the interface between corresponding third drive member or connector122 and third connector sleeve222 are keyed such that rotation of each of drive members or connectors118,120,122 of surgical instrument100 causes a corresponding rotation of the corresponding connector sleeve218,220,222 of shaft assembly200.
• The mating of drive members or connectors118,120,122 of surgical instrument100 with connector sleeves218,220,222 of shaft assembly200 allows rotational forces to be independently transmitted via each of the three respective connector interfaces. The drive members or connectors118,120,122 of surgical instrument100 are configured to be independently rotated by the drive mechanism. In this regard, the controller has a function selection module (not shown) of the drive mechanism selects which drive member or connector118,120,122 of surgical instrument100 is to be driven by an input drive component (not shown) of the drive mechanism.
• Since each of drive members or connectors118,120,122 of surgical instrument100 has a keyed and/or substantially non-rotatable interface with respective connector sleeves218,220,222 of shaft assembly200, when shaft assembly200 is coupled to surgical instrument100, rotational force(s) are selectively transferred from the drive mechanism of surgical instrument100 to shaft assembly200, and on to end effector400, as will be discussed in greater detail below.
• The selective rotation of drive member(s) or connector(s)118,120 and/or122 of surgical instrument100 allows surgical instrument100 to selectively actuate different functions of end effector400. As will be discussed in greater detail below, selective and independent rotation of first drive member or connector118 of surgical instrument100 corresponds to the selective and independent opening and closing of end effector400, and driving of a stapling/cutting component of end effector400. Also, the selective and independent rotation of second drive member or connector120 of surgical instrument100 corresponds to the selective and independent articulation of end effector400 transverse to longitudinal axis “X” (seeFIG.1). Additionally, the selective and independent rotation of third drive member or connector122 of surgical instrument100 corresponds to the selective and independent rotation of end effector400 about longitudinal axis “X” (seeFIG.1) relative to instrument housing102 of surgical instrument100.
• In accordance with the present disclosure, the drive mechanism may include a selector gearbox assembly (not shown); a function selection module (not shown), located proximal to the selector gearbox assembly, that functions to selectively move gear elements within the selector gearbox assembly into engagement with a second motor (not shown). The drive mechanism may be configured to selectively drive one of drive members or connectors118,120,122 of surgical instrument100, at a given time.
• As illustrated inFIGS.1 and2, instrument housing102 supports a pair of finger-actuated control buttons124,126 and/or rocker device(s)130 (only one rocker device being shown). Each one of the control buttons124,126 and rocker device(s)130 includes a respective magnet (not shown) that is moved by the actuation of an operator. In addition, the circuit board (not shown) housed in instrument housing102 includes, for each one of the control buttons124,126 and rocker device(s)130, respective Hall-effect switches (not shown) that are actuated by the movement of the magnets in the control buttons124,126 and rocker device(s)130. In particular, located immediately proximal to the control button124 is a respective Hall-effect switch (not shown) that is actuated upon the movement of a magnet within the control button124 upon the operator actuating control button124. The actuation of Hall-effect switch (not shown), corresponding to control button124, causes the circuit board to provide appropriate signals to the function selection module and the input drive component of the drive mechanism to close end effector400 and/or to fire a stapling/cutting cartridge within end effector400.
• Also, located immediately proximal to control button126 is a respective Hall-effect switch (not shown) that is actuated upon the movement of a magnet (not shown) within control button126 upon the operator actuating control button126. The actuation of the Hall-effect switch, corresponding to control button126, causes the circuit board to provide appropriate signals to the function selection module and the input drive component of the drive mechanism to open/close end effector400.
• In addition, located immediately proximal to rocker device130 is a respective Hall-effect switch (not shown) that is actuated upon the movement of a magnet (not shown) within rocker device130 upon the operator actuating rocker device130. The actuation of the Hall-effect switch, corresponding to rocker device130, causes the circuit board to provide appropriate signals to the function selection module and the input drive component of the drive mechanism to rotate end effector400 relative to shaft assembly200 or rotate end effector400 and shaft assembly200 relative to instrument housing102 of surgical instrument100. Specifically, movement of rocker device130 in a first direction causes end effector400 and/or shaft assembly200 to rotate relative to instrument housing102 in a first direction, while movement of rocker device130 in an opposite, e.g., second, direction causes end effector400 and/or shaft assembly200 to rotate relative to instrument housing102 in an opposite, e.g., second, direction.
• Turning now toFIGS.1-26, shaft assembly200 will be shown in detail and described. Shaft assembly200 is configured to communicate the rotational forces of first, second and third rotatable drive members or connectors118,120, and122 of surgical instrument100 to end effector400. As mentioned above, shaft assembly200 is configured for selective connection to surgical instrument100.
• As seen inFIGS.1,2 and4, shaft assembly200 includes an elongate, substantially rigid, outer tubular body210 having a proximal end210aand a distal end210b; a transmission housing212 connected to proximal end210aof tubular body210 and being configured for selective connection to surgical instrument100; and an articulating neck assembly230 connected to distal end210bof elongate body portion210.
• Transmission housing212 is configured to house a pair of gear train systems therein for varying a speed/force of rotation (e.g., increase or decrease) of first, second and/or third rotatable drive members or connectors118,120, and/or122 of surgical instrument100 before transmission of such rotational speed/force to end effector400.
• Transmission housing212 of shaft assembly200 is configured and adapted to connect to connecting portion108aof upper housing portion108 of surgical instrument100. As seen inFIGS.3-5, transmission housing212 of shaft assembly200 includes a shaft coupling assembly214 supported at a proximal end thereof.
• As seen inFIGS.5 and20-25, transmission housing212 and shaft coupling assembly214 rotatably support a first proximal or input drive shaft224a, a second proximal or input drive shaft226a, and a third drive shaft228.
• Shaft coupling assembly214 is configured to rotatably support first, second and third connector sleeves218,220 and222, respectively. Each of connector sleeves218,220,222 is configured to mate with respective first, second and third drive members or connectors118,120,122 of surgical instrument100, as described above. Each of connector sleeves218,220,222 is further configured to mate with a proximal end of respective first input drive shaft224a, second input drive shaft226a, and third drive shaft228.
• Shaft drive coupling assembly214 includes a first, a second and a third biasing member218a,220aand222adisposed distally of respective first, second and third connector sleeves218,220,222. Each of biasing members218a,220aand222ais disposed about respective first proximal drive shaft224a, second proximal drive shaft226a, and third drive shaft228. Biasing members218a,220aand222aact on respective connector sleeves218,220 and222 to help maintain connector sleeves218,220 and222 engaged with the distal end of respective drive rotatable drive members or connectors118,120,122 of surgical instrument100 when shaft assembly200 is connected to surgical instrument100.
• In particular, first, second and third biasing members218a,220aand222afunction to bias respective connector sleeves218,220 and222 in a proximal direction. In this manner, during connection of shaft assembly200 to surgical instrument100, if first, second and or third connector sleeves218,220 and/or222 is/are misaligned with the drive members or connectors118,120,122 of surgical instrument100, first, second and/or third biasing member(s)218a,220aand/or222aare compressed. Thus, when the drive mechanism of surgical instrument100 is engaged, drive members or connectors118,120,122 of surgical instrument100 will rotate and first, second and/or third biasing member(s)218a,220aand/or222awill cause respective first, second and/or third connector sleeve(s)218,220 and/or222 to slide back proximally, effectively coupling drive members or connectors118,120,122 of surgical instrument100 to respective first input drive shaft224a, second input drive shaft226a, and third drive shaft228.
• In use, during a calibration of surgical instrument100, each of drive connectors118,120,122 of surgical instrument100 is rotated and the bias on connector sleeve(s)218,220 and222 properly seats connector sleeve(s)218,220 and222 over the respective drive connectors118,120,122 of surgical instrument100 when the proper alignment is reached.
• Shaft assembly200 includes a first and a second gear train system240,250, respectively, disposed within transmission housing212 and tubular body210, and adjacent coupling assembly214. As mentioned above, each gear train system240,250 is configured and adapted to vary a speed/force of rotation (e.g., increase or decrease) of first and second rotatable drive connectors118 and120 of surgical instrument100 before transmission of such rotational speed/force to end effector400.
• As seen inFIGS.5 and6, first gear train system240 includes first input drive shaft224a, and a first input drive shaft spur gear242akeyed to first input drive shaft224a. First gear train system240 also includes a first transmission shaft244 rotatably supported in transmission housing212, a first input transmission spur gear244akeyed to first transmission shaft244 and engaged with first input drive shaft spur gear242a, and a first output transmission spur gear244bkeyed to first transmission shaft244. First gear train system240 further includes a first output drive shaft246arotatably supported in transmission housing212 and tubular body110, and a first output drive shaft spur gear246bkeyed to first output drive shaft246aand engaged with first output transmission spur gear244b.
• In accordance with the present disclosure, first input drive shaft spur gear242aincludes 10 teeth; first input transmission spur gear244aincludes 18 teeth; first output transmission spur gear244bincludes 13 teeth; and first output drive shaft spur gear246bincludes 15 teeth. As so configured, an input rotation of first input drive shaft224ais converted to an output rotation of first output drive shaft246aby a ratio of 1:2.08.
• As mentioned above, a proximal end of first input drive shaft224ais configured to support first connector sleeve218.
• In operation, as first input drive shaft spur gear242ais rotated, due to a rotation of first connector sleeve258 and first input drive shaft224a, as a result of the rotation of the first respective drive connector118 of surgical instrument100, first input drive shaft spur gear242aengages first input transmission spur gear244acausing first input transmission spur gear244ato rotate. As first input transmission spur gear244arotates, first transmission shaft244 is rotated and thus causes first output drive shaft spur gear246b, that is keyed to first transmission shaft244, to rotate. As first output drive shaft spur gear246brotates, since first output drive shaft spur gear246bis engaged therewith, first output drive shaft spur gear246bis also rotated. As first output drive shaft spur gear246brotates, since first output drive shaft spur gear246bis keyed to first output drive shaft246a, first output drive shaft246ais rotated.
• As will be discussed in greater detail below, shaft assembly200, including first gear system240, functions to transmit operative forces from surgical instrument100 to end effector400 in order to operate, actuate and/or fire end effector400.
• As seen inFIGS.5 and7, second gear train system250 includes second input drive shaft226a, and a second input drive shaft spur gear252akeyed to second input drive shaft226a. Second gear train system250 also includes a first transmission shaft254 rotatably supported in transmission housing212, a first input transmission spur gear254akeyed to first transmission shaft254 and engaged with second input drive shaft spur gear252a, and a first output transmission spur gear254bkeyed to first transmission shaft254.
• Second gear train system250 further includes a second transmission shaft256 rotatably supported in transmission housing212, a second input transmission spur gear256akeyed to second transmission shaft256 and engaged with first output transmission spur gear254bthat is keyed to first transmission shaft254, and a second output transmission spur gear256bkeyed to second transmission shaft256.
• Second gear train system250 additionally includes a second output drive shaft258arotatably supported in transmission housing212 and tubular body210, and a second output drive shaft spur gear258bkeyed to second output drive shaft258aand engaged with second output transmission spur gear256b.
• In accordance with the present disclosure, second input drive shaft spur gear252aincludes 10 teeth; first input transmission spur gear254aincludes 20 teeth; first output transmission spur gear254bincludes 10 teeth; second input transmission spur gear256aincludes 20 teeth; second output transmission spur gear256bincludes 10 teeth; and second output drive shaft spur gear258bincludes 15 teeth. As so configured, an input rotation of second input drive shaft226ais converted to an output rotation of second output drive shaft258aby a ratio of 1:6.
• As mentioned above, a proximal end of second input drive shaft226ais configured to support second connector sleeve220.
• In operation, as second input drive shaft spur gear252ais rotated, due to a rotation of second connector sleeve260 and second input drive shaft226a, as a result of the rotation of the second respective drive connector120 of surgical instrument100, second input drive shaft spur gear252aengages first input transmission spur gear254acausing first input transmission spur gear254ato rotate. As first input transmission spur gear254arotates, first transmission shaft254 is rotated and thus causes first output transmission spur gear254b, that is keyed to first transmission shaft254, to rotate. As first output transmission spur gear254brotates, since second input transmission spur gear256ais engaged therewith, second input transmission spur gear256ais also rotated. As second input transmission spur gear256arotates, second transmission shaft256 is rotated and thus causes second output transmission spur gear256b, that is keyed to second transmission shaft256, to rotate. As second output transmission spur gear256brotates, since second output drive shaft spur gear258bis engaged therewith, second output drive shaft spur gear258bis rotated. As second output drive shaft spur gear258brotates, since second output drive shaft spur gear258bis keyed to second output drive shaft258a, second output drive shaft258ais rotated.
• As will be discussed in greater detail below, shaft assembly200, including second gear train system250, functions to transmit operative forces from surgical instrument100 to end effector400 in order rotate shaft assembly200 and/or end effector400 relative to surgical instrument100.
• As mentioned above and as seen inFIGS.5 and8, transmission housing212 and shaft coupling assembly214 rotatably support a third drive shaft228. Third drive shaft228 includes a proximal end228aconfigured to support third connector sleeve222, and a distal end228bextending to and operatively connected to an articulation assembly270 as will be discussed in greater detail below.
• As seen inFIG.4, elongate, outer tubular body210 of shaft assembly200 includes a first half section211aand a second half section211bdefining at least three longitudinally extending channels through outer tubular body210 when half sections211a,211bare mated with one another. The channels are configured and dimensioned to rotatably receive and support first output drive shaft246a, second output drive shaft258a, and third drive shaft228 as first output drive shaft246a, second output drive shaft258a, and third drive shaft228 extend from transmission housing212 to articulating neck assembly230. Each of first output drive shaft246a, second output drive shaft258a, and third drive shaft228 are elongate and sufficiently rigid to transmit rotational forces from transmission housing220 to articulating neck assembly230.
• Turning now toFIGS.4 and9-16, articulating neck assembly230 is shown and described. Articulating neck assembly230 includes a proximal neck housing232, a plurality of links234 connected to and extending in series from proximal neck housing232; and a distal neck housing236 connected to and extending from a distal-most link of the plurality of links234. It is contemplated that, in any of the embodiments disclosed herein, that the shaft assembly may have a single link or pivot member for allowing the articulation of the end effector. It is contemplated that, in any of the embodiments disclosed herein, that the distal neck housing can be incorporated with the distal most link.
• Each link234 includes cooperating knuckles and clevises formed on each of a proximal surface234aand a distal surface234bthereof. Proximal neck housing232 includes knuckles and/or clevises that operatively engage with the knuckles and/or clevises of a proximal-most link. Distal neck housing236 includes knuckles and/or clevises that operatively engage with the knuckles and/or clevises of a distal-most link. The knuckles and clevises of adjacent neck housings232,236 and links234 operatively engage with one another to define a direction and a degree of articulation of neck assembly230.
• Neck assembly230 is configured to enable end effector400 to move between a substantially linear configuration and a substantially angled, off-axis or articulated configuration. In accordance with the present disclosure, it is contemplated that neck assembly230 is capable of articulating in a single plane and is capable of articulating approximately 90°, and even greater than 90°.
• Each link234 defines a first lumen234c(seeFIG.12) therein for passage of a first drive cable or member266 therethrough; a first pair of opposed lumens234d1,234d2, for passage of a pair of articulation cables262,264 therethrough; and a second lumen234efor passage of a second drive cable or member268 therethrough. As seen inFIG.12, first and second lumens234c,234eare diametrically opposed to one another and offset 90° relative to lumens234d1,234d2. Each of first drive cable or member266 and second drive cable or member268 includes a proximal end keyed to a distal end of respective first output drive shaft246aand second output drive shaft258a. Each of first and second drive cables266,268 is fabricated from a material that is both flexible and torsionally stiff (capable of transmitting rotational forces or torque), such as, for example, stainless steel and the like.
• As seen inFIGS.13-16, proximal neck housing232 of neck assembly230 supports an articulation assembly270 configured and adapted to impart articulation to neck assembly230 and/or end effector400. Articulation assembly270 includes a pair of opposed gear racks272,274 engaged with and on opposed sides of a pinion gear276. Racks272,274 are axially slidably supported in proximal neck housing232 and pinion gear276 is rotatably supported in proximal neck housing232.
• As seen inFIGS.12,13 and17, rack274 is attached to a threaded shaft272aextending proximally therefrom and that is in threaded engagement with a distal end of an internally threaded nut278. Threaded nut278 is rotatably supported and axially fixed within a pocket232aformed in proximal neck housing232. A proximal end of threaded nut278 is keyed to a distal end of third drive shaft228. While threaded shaft272ais shown extending from rack274, it is understood, and within the scope of the present disclosure, that the threaded shaft may extend from rack272 without departing from the principles of the present disclosure.
• Articulation cables262,264 include proximal ends that are secured to and extend from a respective distal end of racks272,274. Each articulation cable262,264 includes a distal end that extends through respective opposed lumens234d1,234d2 of links234 and that is secured to or anchored in distal neck housing234 or the distal most link.
• In operation, to articulate neck assembly230 in a first direction, third drive shaft228 is rotated in a first direction, as described above, to rotate threaded nut278 and axially displace threaded shaft272adistally to axially displace rack274 distally (seeFIG.16). As rack274 is displaced axially, in a distal direction, rack274 causes pinion gear276 to be rotated and to thus act on rack272, to axially displace rack272 in a proximal direction. As rack272 is axially displaced in a proximal direction, rack272 causes articulation cable262 to be drawn in a proximal direction and thereby articulate neck assembly230, as illustrated inFIG.16. Neck assembly230 is permitted to articulate since axially displacement of rack274, in a distal direction, results in axial, distal displacement of articulation cable264.
• Distal neck housing236 supports a first gear train280 and a second gear train290. First gear train280 functions to transmit a rotation of first drive cable or member266 to end effector400. Second gear train290 functions to transmit a rotation of second drive cable or member268 to end effector400.
• As seen inFIGS.20-25, first gear train280 of distal neck housing236 includes a first spur gear282arotatably supported in distal neck housing236 and keyed to a distal end of first drive cable266 of shaft assembly200. First gear train280 of distal neck housing236 further includes a second spur gear282brotatably supported in distal neck housing236 and engaged with first spur gear282a. First gear train280 of distal neck housing236 also includes a third spur gear282crotatably supported in distal neck housing236 and engaged with second spur gear282b.
• Third spur gear282cincludes a bore282dformed along a central axis thereof that is configured for mating receipt of a drive axle426 of end effector400 (seeFIG.26).
• In accordance with the present disclosure, first spur gear282aincludes 8 teeth; second spur gear282bincludes 10 teeth; and third spur gear282cincludes 8 teeth. As so configured, an input rotation of first drive cable266 is converted to an output rotation of third spur gear282cof distal neck housing236 by a ratio of 1:1. Additionally, first gear train280 is provided to rotatably and mechanically connect first drive cable266 to drive axle426 of end effector400.
• In operation, as first drive cable266 is rotated, due to a rotation of first output drive shaft246a(as described above), said rotation is transmitted to first spur gear282aof first gear train280. As first spur gear282ais rotated, third spur gear282cis rotated due to the inter-engagement of first spur gear282aand third spur gear282cby second spur gear282b. As third spur gear282cis rotated, when end effector400 is connected to shaft assembly200, and specifically, third spur gear282cis connected to drive axle426 of end effector400, a rotation of third spur gear282cresults in rotation of drive axle426 of end effector400 and actuation of end effector400.
• As seen inFIGS.20-25, second gear train290 of distal neck housing236 includes a first spur gear292arotatably supported in distal neck housing236 and keyed to a distal end of second drive cable268 of shaft assembly200. Second gear train290 of distal neck housing236 further includes a second spur gear292brotatably supported in distal neck housing236 and engaged with first spur gear292a. Second gear train290 of distal neck housing236 also includes a non-circular shaft292cextending from second spur gear292b(seeFIG.21). Non-circular shaft292cis keyed to a rotation hub294 such that rotation of non-circular shaft292cresults in rotation of rotation hub294.
• Rotation hub294 is provided between a shaft of third spur gear282c, of first gear train280, that defines the bore282dthereof and rotation hub294 transmitting relative rotation of third spur gear282cof first gear train280 to rotation hub294 of second gear train290.
• In accordance with the present disclosure, first spur gear292aincludes 8 teeth (which functions as the input); and second spur gear292bincludes 10 teeth. As so configured, an input rotation of second drive cable268 is converted to an output rotation of rotation hub294. The gear ratio for this is 1:0.8. Additionally, second gear train290 is provided to rotatably and mechanically connect second drive cable268 to rotation hub294 of distal neck housing236 of neck assembly230.
• In operation, as second drive cable268 of shaft assembly200 is rotated, due to a rotation of second output drive shaft258a(as described above), said rotation is transmitted to first spur gear292aof first gear train290. As first spur gear292ais rotated, non-circular shaft292cis rotated due to its connection with second spur gear292b. As non-circular shaft292cis rotated, when end effector400 is connected to shaft assembly200, and specifically, rotation hub294 is connected to alignment stems424a,424bof end effector400, a rotation of rotation hub294 results in rotation of end effector400.
• Shaft assembly200 further includes an end effector coupling assembly310 supported at a distal end of distal neck housing236 of articulating neck assembly230. End effector coupling assembly310 includes a collar312 rotatably supported on and extending distally from distal neck housing236 and being biased to a first radial portion. Collar312 is rotatable from a first radial position to a second radial position, wherein end effector400 is matable to end effector coupling assembly310, and returns, by way of the bias, to the first radial position, to lock end effector400 to shaft assembly200.
• It is contemplated that collar312 includes at least one nub312aextending radially inward from inner surface thereof for receipt in a respective complementary structure422aformed in an outer surface of end effector400 to connect end effector400 to shaft assembly200 in the manner of a bayonet-type connection. Other forms of connection are contemplated, such as, detents, threaded connections, etc.
• As seen inFIGS.12-14,17 and18, shaft assembly200 includes a cable tensioning assembly320. Cable tensioning assembly320 includes a clevis322 slidably supported in proximal neck housing232, for axial displacement therewithin. Clevis322 rotatably supports pinion gear276 of articulation assembly270. Cable tensioning assembly320 includes an adjustment screw324, rotatably supported in proximal neck housing232 and retained against axial displacement. Adjustment screw324 is threadably connected to clevis322 such that rotation of adjustment screw324 results in axial displacement of clevis322.
• In operation, during an assembly of shaft assembly200, an operator rotates adjustment screw324 in a direction so as to axially displace clevis322 in a proximal direction. As clevis322 is axially displaced, in a proximal direction, clevis322 pulls on pinion gear276 of articulation assembly270. As pinion gear276 is axially displaced, in a proximal direction, pinion gear276 acts on racks272,274 to draw racks272,274 in a proximal direction. As racks272,274 are drawn in a proximal direction, with articulation cables262,264 respectively connected thereto, and with distal ends of articulation cables262,264 fixed or anchored in place, articulation cables262,264 are caused to be tensioned. It is contemplated that a set screw328 (seeFIG.12) may be provided to fix the position of adjustment screw324 and help to maintain articulation cables262,264 tensioned.
• It is contemplated that over time and/or following a number of uses, that an end user of shaft assembly200 may be able to access adjustment screw324 and re-tension articulation cables262,264 as needed or necessary.
• Turning now toFIGS.26-49, end effector400 is shown and described. End effector400 is configured and adapted to apply a plurality of linear rows of fasteners433. In certain embodiments, the fasteners are of various sizes, and, in certain embodiments, the fasteners have various lengths or rows, e.g., about 30, 45 and 60 mm in length.
• As seen inFIGS.26-28, end effector400 includes a mounting portion420 (FIG.28) configured for selective connection to end effector coupling assembly310 of shaft assembly200. End effector400 further includes a jaw assembly430 connected to and extending distally from mounting portion420. Jaw assembly430, as will be discussed in greater detail below, includes a lower jaw432 pivotally connected to mounting portion420 and being configured to selectively support a cartridge assembly410 therein, and an upper jaw442 secured to mounting portion420 and being movable, relative to lower jaw432, between approximated and spaced apart positions.
• As seen inFIGS.26-28, mounting portion420 includes a coupling member422 secured to a proximal end thereof. Coupling member422 defines a substantially J-shaped channel422a(seeFIGS.26-28) formed in a radial outer surface thereof that is configured and dimensioned for selective connection with complementary structure formed on or extending radially inward from collar312 of end effector coupling assembly310, as described above. Coupling member422 further includes a pair of spaced apart alignment stems424a,424bprojecting proximally therefrom, for receipt in respective alignment bores310a,310bformed in a distal surface of end effector coupling assembly310.
• The alignment stems424a,424balong with the alignment bores310a,310bare used to align and couple end effector400 to end effector coupling assembly310 of shaft assembly200. The nub312aof collar312 and the J-shaped channel422aof coupling member422 may define a conventional bayonet-type coupling which facilitates quick and easy engagement and removal of end effector400 from shaft assembly200 before, during or after a surgical procedure.
• Mounting portion420 further includes, as seen inFIGS.26,28-31,34 and35 a drive axle426 rotatably supported therein. Drive axle426 includes a multi-faceted, proximal head426aprojecting proximally from coupling member422 and being configured for mating engagement with third spur gear282cof first gear train280 of distal neck housing236 and first gear train system240 of shaft assembly200, when end effector400 is coupled to shaft assembly200. Drive axle426 further includes multi-faceted, a distal head426bprojecting distally from coupling member422 and being configured for mating engagement with a threaded drive shaft464 supported in lower jaw432 of jaw assembly430. Drive axle426 functions to transmit rotational drive forces from third spur gear282cof first gear train280 of distal neck housing236 and of first gear train system240 of shaft assembly200, which defines an axis of rotation, to drive screw464 of lower jaw432 of jaw assembly430, which defines an axis of rotation that is different than the axis of rotation of third spur gear282c.
• As seen inFIGS.28-31,34-36 and39-43, lower jaw432 of jaw assembly430 includes a drive screw464 rotatably supported therein and extending substantially an entire length thereof. Drive screw464 includes a female coupling member464asupported on a proximal end thereof and being configured for receipt of multi-faceted, distal head426bof drive axle426. Drive screw464 is axially and laterally fixed within lower jaw432 of jaw assembly430 by a thrust plate465, or the like, which is secured to jaw assembly430 and at least partially extends into an annular channel464aformed in drive screw464. In operation, rotation of drive axle426 results in concomitant rotation of drive screw464.
• As seen inFIGS.28-43, end effector400 includes a drive beam466 slidably supported in lower jaw432 of jaw assembly430. Drive beam466 includes a substantially I-shaped cross-sectional profile and is configured to approximate lower jaw432 and upper jaw442, and to axially displace an actuation sled468 through lower jaw432. As seen inFIG.33, drive beam466 includes a vertically oriented support strut466a; a lateral projecting member466bformed atop support strut466aand being configured to engage and translate with respect to an exterior camming surface of upper jaw442 to progressively close jaw assembly430; and a retention foot466chaving an internally threaded bore for threadable connection to threaded drive shaft464. Since drive beam466 is prevented from rotation by the engagement of strut466aand/or cam member466bwith upper jaw442, as drive screw464 is rotated, retention foot466c, and in turn, drive beam466 is axially translated relative to lower jaw432.
• Drive beam466 includes a lock clip467 extending distally from strut466a. Lock clip467 defines a hook467aconfigured to engage a window450cformed in a knife sled450, as will be discussed in greater detail below. Hook467aof lock clip467 is biased to extend away from knife sled450. Prior to firing the cartridge assembly410, the drive beam466 is at a proximal-most position in lower jaw432 and actuation sled418 and knife sled450 are at a proximal-most position in cartridge body412, as seen inFIGS.36 and37. Lock clip467, prior to firing, is disengaged from window450cof knife sled450 and extends into a relief412edefined in a wall of knife slot412b.
• Lower jaw432 is in the form of a channel and is configured and adapted to selectively receive a disposable staple cartridge assembly410 therein. Staple cartridge assembly410 includes a cartridge body412 defining a plurality of rows of staple retaining slots412aand a longitudinally extending knife slot412bdisposed between pairs of rows of staple retaining slots412a. Staple cartridge assembly410 also includes a plurality of staples433 disposed, one each, in the plurality of retaining slots412a. Staple cartridge assembly410 further includes a plurality of staple pushers416 supported therein, wherein the staple pushers416 are aligned one each within retaining slots412asuch that a single staple pusher416 is positioned under a respective staple433 which is retained within slot412a. Staple pushers416 may be formed such that they are attached to each other in a pusher member having groups of two or three pushers, wherein the pusher member may have offset oriented pushers. One or more actuating surfaces is provided on a lower surface of the pusher member (not shown).
• Staple cartridge assembly410 includes an actuation sled418 slidably supported against a lower surface of cartridge body412 and being engageable by drive beam466. Actuation sled418 includes upstanding cam wedges418aconfigured to exert a driving force on staple pushers416, by contacting the actuating surfaces, which drives staples414 from staple cartridge assembly410, as described in greater detail below.
• Cartridge body412 defines a plurality of spaced apart longitudinal channels412c(seeFIG.36) extending therethrough to accommodate the upstanding cam wedges418aof actuation sled418. Channels412ccommunicate with the plurality of retaining slots412awithin which the plurality of staples433 and pushers416 are respectively supported.
• As seen inFIGS.28-43, staple cartridge assembly410 further includes a knife sled450 slidably supported within knife slot412bof cartridge body412 and being interposed between drive beam466 and actuation sled468. As seen inFIG.33, knife sled450 defines a knife blade450aextending from an upper surface thereof and oriented distally, wherein knife blade450aextends through knife slot412bof cartridge body412. Knife sled450 includes a lock-out spring451 extending distally therefrom for engaging a lock-out notch412dformed in a surface of cartridge body412 (seeFIG.37), as will be discussed in greater detail below. Lock-out spring451 is biased toward lock-out notch412d. Prior to firing of cartridge assembly410, with actuation sled418 and knife sled450 at a proximal-most position in cartridge body412, as seen inFIG.34-37, lock-out spring451 is blocked by actuation sled418 from entering lock-out notch412dof cartridge body412.
• Staple cartridge assembly410 includes a bottom cover or retainer415 configured to maintain the plurality of staple pushers416, actuation sled418 and knife sled450 within cartridge body412. Retainer415 supports and aligns the plurality of pushers416 prior to engagement thereof by the actuation sled418. During operation, as actuation sled418 translates through staple cartridge assembly410, the angled leading edges of cam wedges418aof actuation sled418 sequentially contact pushers416, causing the pushers416 to translate vertically within retaining slots412a, urging the staples433 therefrom. Also, as knife sled450 translates through knife slot412bof cartridge body412, knife blade450asevers tissue and retaining sutures that extend across knife slot412bof cartridge body412.
• In operation, as drive screw464 is rotated, in a first direction, to advance drive beam466, as described above, drive beam466 is advanced into contact with knife sled450 and actuation sled418 to distally advance or push knife sled450 and actuation sled418 through cartridge body412 and lower jaw432. As drive beam466 is continually driven in the distal direction, drive beam466 maintains contact with knife sled450 and actuation sled418, thereby pushing knife sled450 and actuation sled418 in the distal direction and to approximate lower jaw430 and upper jaw440, as laterally projecting member466bof drive beam466 pushes down on the exterior camming surface of upper jaw440, to eject the staples414 and fasten tissue, and to simultaneously dissect tissue with knife blade450a. Knife sled450, actuation sled418 and drive beam466 travel through cartridge body412 thereby fastening and severing tissue.
• As seen inFIGS.37 and38, as drive beam466 is advanced distally, hook467aof lock clip467 exits relief412eand is cammed into window450cof knife sled450 as hook467aenters knife slot412bof cartridge body412. Drive screw464 is rotated until actuation sled418, knife sled450 and drive beam466 reach a distal-most end of cartridge body412 and/or lower jaw432, for a complete firing.
• Following a complete or partial firing, drive screw464 is rotated in an opposite direction to retract drive beam466. Since and knife sled450 is connected to drive beam466 by lock clip467, as described above, as drive beam466 is retracted, knife sled450 is also retracted. Actuation sled418 will tend to remain at a distal or distal-most position due to its frictional engagement in channels412cof cartridge body412 (seeFIG.40). Drive screw464 is rotated until drive beam466 and knife sled450 are returned to the proximal-most position. Once drive beam466 and knife sled450 are returned to the proximal-most position, hook467aof lock clip467 is permitted to re-enter relief412e, due to its own resiliency, and disengage from window450cof knife sled450. As such, drive beam466 is disengaged from knife sled450, and staple cartridge assembly410 is free to be removed from lower jaw432.
• Also, when drive beam466 and knife sled450 are returned to the proximal-most position, with actuation sled418 now separated from knife sled450, since lock-out spring451 is biased toward lock-out notch412d, as seen inFIG.43, lock-out spring451, which is attached to knife sled450, is now free to enter lock-out notch412dand prevent knife sled450 and/or drive beam466 being re-advanced, thereby locking-out staple cartridge assembly410.
• In order for drive beam466 to be re-advanced, a new, un-fired staple cartridge assembly410 needs to be loaded into lower jaw432.
• Upper jaw442 of jaw assembly430 functions as an anvil against which the staples433 form when actuation sled418 is advanced during a firing of surgical instrument100. In particular, upper jaw442 includes an anvil plate443, secured to a cover housing444, in juxtaposed relation to staple cartridge assembly410. Anvil plate443 defines a plurality of staple forming pockets (not shown), arranged in longitudinally extending rows that cooperate with the rows of staple retaining slots412aof staple cartridge assembly410, when staple cartridge assembly410 is disposed in lower jaw432.
• Lower jaw432 is pivotably connected to mounting portion420 by way of appropriate pivot pins445 or the like extending through a pair of spaced apart shoulders432a,432bdisposed near a proximal end thereof. Shoulders432a,432bof lower jaw432 extend into reliefs or the like formed in mounting portion420.
• As seen inFIG.28, jaw assembly430 includes at least one biasing member447, in the form of a compression spring or the like, disposed between each shoulder432a,432bof lover jaw432 and a bearing surface of mounting portion420 such that lower jaw432 is spaced from upper jaw442, until closed, to maintain jaw assembly430 in an open position. In use, as jaw assembly430 is closed, by approximating upper jaw442 and lower jaw432, biasing members447 are biased (i.e., compressed) between shoulders432a,432bof lower jaw432 and the bearing surface of mounting portion420.
• Following firing of staple cartridge assembly410, drive screw464 is rotated, in a second direction that is opposite the first direction, to withdraw drive beam466 and knife sled450, as described above. As drive beam466 is withdrawn in a proximal direction, biasing members447 begin to expand to press apart shoulders432a,432bof lower jaw432 from the bearing surface of mounting portion420 to separate the upper jaw442 from the lower jaw432 to open jaw assembly430.
• In accordance with the present disclosure, cartridge body412 of staple cartridge assembly410 may be configured and adapted to selectively support a surgical buttress on a tissue contact surface thereof. With reference toFIGS.28, cartridge body412 of staple cartridge assembly410 defines a proximal pair of recesses formed near a proximal end thereof and disposed, one each, on opposed sides of longitudinally extending knife slot412b. Cartridge body412 further defines a distal pair of recesses412eformed near a distal end thereof and disposed, one each, on opposed sides of longitudinally extending knife slot412b. In one embodiment, the distal pair of recesses412eis preferably non-circular and constricting or otherwise arranged so as to frictionally engage and/or pinch an anchor “S”.
• As seen inFIG.28, cartridge body412 further includes a surgical cartridge buttress “B1”, pledget or the like operatively secured to an upper surface or tissue contacting surface thereof, by suture anchors “S1” and “S2”, to overlie at least some of the plurality of staple retaining slots412aand/or at least a portion of a length of longitudinally extending knife slot412b. In particular, an anchor “S1” is cinched around a proximal portion of surgical cartridge buttress “B1” and each of the proximal pair of recesses and an anchor “S2” is cinched around a distal portion of the surgical cartridge buttress “B1” and each of the distal pair of recesses412e. The anchors may comprise a surgical suture.
• In one particular embodiment, a first end of suture anchor “S1” includes a knot, stop or the like (not shown) sized so as to not pass through one recess of the proximal pair of recesses and a second end of suture anchor “S1” passes over, and transversely across, surgical cartridge buttress “B1”, at least once, and back through the other recess of the proximal pair of recesses. For example, the second end of suture anchor “S1” may be pinched or cinched in the other recess of the proximal pair of recesses so as to anchor the second end of the suture anchor “S1” and secure the surgical cartridge buttress “B1” against the tissue contacting surface of cartridge body412. Similarly, a suture anchor “S2” is used to extend transversely across surgical cartridge buttress “B1” and into engagement with the distal pair of recesses412e.
• Surgical cartridge buttress “B1” includes a proximal pair of notches formed in side edges aligned with the proximal pair of recesses of cartridge body412, a distal pair of notches formed in side edges thereof aligned with the distal pair of recesses412eof cartridge body412, and a proximal notch formed in a proximal edge thereof aligned with longitudinally extending knife slot412bwhen cartridge buttress “B1” is secured to cartridge body412. Cartridge buttress “B1” further includes a tongue or tab extending from a distal edge thereof to facilitate with the attachment of cartridge buttress “B1” to cartridge body412 during the assembly process. It is contemplated that a width of cartridge buttress “B1” may be reduced in a proximal portion thereof. It is further contemplated that the tongue is removed from cartridge buttress “B1” following securement of cartridge buttress “B1” to cartridge body412 and prior to packaging or shipment.
• As seen inFIGS.28 and44-47, cartridge body412 of staple cartridge assembly410 includes a cartridge buttress release assembly470 supported in and near a distal end of cartridge body412. Release assembly470 includes a retainer472 supported in a distal end of cartridge body412 at a location near a distal end of longitudinally extending knife slot412band at least partially extending thereacross. Retainer472 includes a body portion472a, a boss472bextending from a surface thereof, and defines a channel or recess427cformed in a surface thereof and extending through a side thereof. When supported in cartridge body412, recess472cof retainer472 is in registration with one of the pair of distal recesses412eof cartridge body412.
• Release assembly470 further includes a pusher member474 having a head portion474apivotally connected to boss472bof retainer472. Pusher member474 further includes a first leg member474bextending from head portion474aand a second leg member474cconnected to a free end of first leg member474bvia a living hinge connection. Pusher member474 further includes piston474econnected to a free end of second leg member474cvia a living hinge connection. Piston474eis slidably disposed and translatable within recess472cof retainer472. In certain other embodiments, the pusher is a linkage assembly having a first link pivotably connected to the cartridge body at one end. The other end of the first link is pivotably connected to a first end of a second link. The opposite, second, end of the second link is confined in the recess of the retainer.
• As seen inFIG.46, release assembly470 includes an unactuated configuration wherein piston474edoes not extend into or overlie the respective one of the pair of distal recesses412eof cartridge body412, and first leg member474band second leg member474care angled with respect to one another and project proximally along longitudinally extending knife slot412bof cartridge body412. It is contemplated that release assembly470 may include a friction fit or snap fit feature for maintaining and/or retaining release assembly470 in the locking or anchoring configuration at all times following the manufacturing/assembly process and prior to a complete firing of surgical instrument100.
• As seen inFIG.47, release assembly470 includes an actuated configuration wherein piston474eextends into or overlies the respective one of the pair of distal recesses412dof cartridge body412 in operative registration therewith, and first leg member474band second leg member474care extended substantially along a common axis.
• In operation, with surgical cartridge buttress “B1” secured against the tissue contacting surface of cartridge body412, during firing of surgical instrument100, as drive beam466 is advanced (i.e., moved from a proximal-most position to a distal-most position), knife blade450aof knife sled450 slices through a central section of proximal suture anchor “S1”, thereby freeing the proximal end of the surgical cartridge buttress “B1” from cartridge body412. During use, as the firing stroke of surgical instrument100 is nearing completion and as actuation sled418 approaches a distal end of longitudinally extending knife slot412bcof cartridge body412, actuation sled418 contacts the living hinge connection between first leg member474band second leg member474c. As actuation sled418 is further advanced distally, actuation sled418 presses against the living hinge connection, causing first leg member474band second leg member474cto extend. As first leg member474band second leg member474cextend, piston474eis translated through recess472cof retainer472. As piston474eis translated through recess472cof retainer472, piston474eengages the second end of suture anchor “S2” and urges the second end of suture anchor “S2” out of the distal recess412dof cartridge body412 that is in registration therewith to release the second end of suture anchor “S2” therefrom. With the second end of suture anchor “S2” released or free from distal recess412dof cartridge body412, the distal end of the surgical cartridge buttress “B1” is free to separate from the tissue contacting surface of cartridge body412.
• As seen inFIG.28, upper jaw442 further includes a surgical anvil buttress “B2”, pledget or the like operatively secured to an upper surface or tissue contacting surface thereof, by anchors “S3” and “S4”, to overlie at least some of the plurality of staple forming pockets and/or at least a portion of a length of a longitudinally extending knife slot of anvil plate443. The anchors may comprise surgical sutures. In particular, a suture anchor “S3” is cinched around a proximal portion of surgical anvil buttress “B2” and each of the proximal pair of recesses and a suture anchor “S4” is cinched around a distal portion of the surgical anvil buttress “B2” and each of a distal pair of recesses443aformed in opposed side edges of anvil plate443.
• In one particular embodiment, a first end of suture anchor “S3” includes a knot, stop or the like (not shown) sized so as to not pass through one recess of the proximal pair of recesses and a second end of suture anchor “S3” passes over, and transversely across, surgical anvil buttress “B2”, at least once, and back through the other recess of the proximal pair of recesses. For example, the second end of suture anchor “S3” may be pinched or cinched in the other recess of the proximal pair of recesses so as to anchor the second end of the suture anchor “S3” and secure the surgical anvil buttress “B2” against the tissue contacting surface of anvil plate443. Similarly, a suture anchor “S4” is used to extend transversely across surgical anvil buttress “B2” and into engagement with the distal pair of recesses443a.
• Surgical anvil buttress “B2” includes a proximal pair of notches formed in side edges aligned with the proximal pair of recesses of anvil plate443, a distal pair of notches formed in side edges thereof aligned with the distal pair of recesses443aof anvil plate443, and a proximal notch formed in a proximal edge thereof aligned with longitudinally extending knife slot when anvil buttress “B2” is secured to anvil plate443. Anvil buttress “B2” further includes a tongue or tab extending from a distal edge thereof to facilitate with the attachment of anvil buttress “B2” to anvil plate443 during the assembly process. It is contemplated that the tongue is removed from anvil buttress “B2” following securement of anvil buttress “B2” to anvil plate443 and prior to packaging or shipment.
• As seen inFIGS.28 and48-49, upper jaw442 of jaw assembly430 includes a suture release assembly474 disposed between anvil plate443 and cover housing444 at a location in operative registration with a distal pair of side recesses443a. Suture release assembly474 includes a link arm475 pivotally connected to anvil plate443 and/or optionally cover housing444. Link arm475 includes a body portion475adefining a pocket or recess475cformed in a first side edge475bthereof and a camming surface475ddefined substantially along an adjacent side or proximal edge thereof. Pocket475chas a substantially arcuate, circular or rounded profile and defines an arcuate relief475ein a side wall thereof. Link arm475 includes a pivot pin extending from body portion475afor pivotally connecting link arm475 to upper jaw442.
• Release assembly474 further includes a pusher bar477 pivotally connected to link arm475 and slidably disposed between anvil plate443 and cover housing444. Pusher bar477 includes a body portion477ahaving a substantially rectangular configuration and a head477b, extending from a corner of body portion477a, and having a substantially circular or rounded configuration. Head477bof pusher bar477 is configured and dimensioned for pivotable and/or rotatable connection in pocket475cof link arm475. Head477bof pusher bar477 includes a stop member477dprojecting from a side edge thereof and into arcuate relief475eof pocket475cof link arm475. A relative distance of rotation of pusher bar477 relative to link arm475 is determined by a relative length of arcuate relief475eand a relative width of stop member477d.
• As seen inFIG.48, suture release assembly474 includes an unactuated configuration wherein pusher bar477 does not extend into or overlie the respective one of the pair of distal recesses443ain operative registration therewith, and a longitudinal axis of link arm475 is oriented substantially parallel with a longitudinal axis of upper jaw442. It is contemplated that suture release assembly474 may include a friction fit or snap fit feature for maintaining and/or retaining suture release assembly474 in the locking or anchoring configuration at all times following the manufacturing/assembly process and prior to a complete firing of the surgical stapling apparatus.
• As seen inFIG.49, suture release assembly474 includes an actuated configuration wherein pusher bar477 extends into or overlies the respective one of the pair of distal recesses443ain operative registration therewith, and a longitudinal axis of link arm475 is oriented substantially transverse to the longitudinal axis of upper jaw442.
• With reference toFIGS.28 and34-43, in operation, with a surgical anvil buttress (not shown) secured against the lower surface of anvil plate443, during firing of the surgical stapling apparatus, as drive beam466 is advanced (i.e., moved from a proximal-most position to a distal-most position), knife blade450aslices through a central section of the proximal suture (not shown), thereby freeing the proximal end of the surgical anvil buttress (not shown) from upper jaw442. During use, as the firing stroke of the surgical instrument is nearing completion and as drive beam466 approaches a distal-most end of the knife slot of anvil plate443, as seen inFIG.49, actuation sled418 contacts camming surface475dof link arm475, thus urging link arm475 to rotate or pivot around the pivot pin and, in turn, urging pusher bar477 to translate in the direction of the slot. As pusher bar477 is translated, pusher bar477 comes into contact with and urges the second end of suture “S4” out of the distal recess443athat is registration therewith to release the second end of suture “S4” therefrom. With the second end of surgical suture “S4” released or free from distal recess443a, the distal end of the surgical anvil buttress “B2” is free to separate from the tissue contacting surface of anvil plate443.
• Exemplary surgical buttresses “B” for use with the staple cartridge assembly410 and/or anvil plate443 disclosed herein are shown and described in commonly assigned U.S. Pat. Nos. 5,542,594, 5,908,427, 5,964,774, 6,045,560, and 7,823,592; commonly assigned U.S. application Ser. No. 12/579,605, filed on Oct. 15, 2009 (now U.S. Pat. No. 8,157,151); commonly assigned U.S. application Ser. No. 11/241,267, filed on Sep. 30, 2005 (now U.S. Pat. No. 7,938,307); and U.S. application Ser. No. 13/097,194, filed on Apr. 29, 2011 (now U.S. Pat. No. 8,365,972), the entire contents of each of which are incorporated by reference herein.
• Surgical buttresses “B” may be fabricated from a suitable biocompatible and bioabsorbable material. Surgical buttresses “B” may be fabricated from a non-absorbent material which does not retain fluid. Surgical buttresses “B” may be fabricated from “BIOSYN” made from GLYCOMER 631 (a block copolymer), a synthetic polyester composed of glycolide, dioxanone and trimethylene carbonate.
• One block of the resulting copolymer contains randomly combined units derived from p-dioxanone (1,4-dioxan-2-one) and trimethylene carbonate (1,3-dioxan-2-one). The second block of the copolymer contains randomly combined units derived from glycolide and p-dioxanone. The resulting polyester is an ABA triblock terpolymer possessing about 60% glycolide, about 14% dioxanone, and about 26% trimethylene carbonate.
• The surgical buttress may comprise polymers or copolymers of glycolide, lactide, poly caprolactone, trimethylene carbonate, dioxanone, caprolactone, and may be molded, extruded, etc. into a desired shape, or formed into a knitted, woven, braided, non-woven or felted material.
• In a further embodiment, an electromechanical, hand-held, powered surgical system10 as discussed above has an alternative neck assembly. Electromechanical surgical system10 is an electromechanical, hand-held, powered surgical instrument100 that is configured for selective attachment to of a plurality of different end effectors, via the shaft assembly200, as discussed above.FIGS.50-66, show the alternative proximal neck assembly230, according to certain embodiments of the present disclosure, is generally designated as1232. Otherwise, the system10 is as discussed above.
• As seen inFIGS.55,56,61,65 and66, proximal neck housing1232 of neck assembly230 supports an articulation assembly1270 configured and adapted to impart articulation to neck assembly230 and the end effector400. Articulation assembly1270 includes a pair of opposed gear racks1272,1274 engaged with and on opposed sides of a pinion gear1276. SeeFIG.55. Racks1272,1274 are axially and movably supported in proximal neck housing1232 and the pinion gear1276 is rotatably supported in proximal neck housing1232.
• As seen inFIG.55, rack1274 is attached to a threaded shaft1272aextending proximally therefrom and threaded shaft1272ais in threaded engagement with a distal end of an internally threaded nut1278. Threaded nut1278 is rotatably supported and axially fixed within a pocket1232a(FIGS.65 and66) formed in proximal neck housing1232. A proximal end of threaded nut1278 is keyed to a distal end of third drive shaft228 (seeFIG.5). While threaded shaft1272ais shown extending from rack1274, it is understood, and within the scope of the present disclosure, that the threaded shaft may extend from rack1272 without departing from the principles of the present disclosure.
• Articulation cables262,264 (seeFIG.12) include proximal ends that are secured to and extend from a respective distal end of racks1272,1274. Each articulation cable262,264 includes a distal end that extends through respective opposed lumens of links234, and that are secured to or anchored in distal neck housing234, as described above.
• In operation, to articulate neck assembly230 in a first direction, the third drive shaft228 is rotated in a first direction, as described above, to rotate threaded nut1278 and axially displace threaded shaft1272adistally to axially displace rack1274 distally. As rack1274 is displaced axially in a distal direction, rack1274 causes pinion gear1276 to be rotated and to thus act on rack1272, to axially displace rack1272 in a proximal direction. As rack1272 is axially displaced in a proximal direction, rack1272 causes articulation cable262 to be drawn in a proximal direction and thereby articulate neck assembly230, in a manner similar to or identical to that which is shown inFIG.16. Neck assembly230 is articulated since axial displacement of rack1274, in a distal direction, results in axial, distal displacement of articulation cable264.
• As seen inFIGS.50-52,55,56,61, and63-66, neck assembly230 of shaft assembly200 includes a cable tensioning assembly1320. Cable tensioning assembly1320 includes a clevis1322 slidably supported in proximal neck housing1232, for axial displacement therewithin. Clevis1322 rotatably supports pinion gear1276 of articulation assembly1270. Cable tensioning assembly1320 includes an adjustment screw1324, rotatably supported in proximal neck housing1232 and retained against axial displacement. Adjustment screw1324 is threadably connected to clevis1322 such that rotation of adjustment screw1324 results in axial displacement of clevis1322.
• Cable tensioning assembly1320 also includes a biasing member1325 interposed between a head of adjustment screw1324 and a surface of proximal neck housing1232 to ensure a continuous tensioning load is exerted on articulation cables262,264.
• During an assembly of shaft assembly200, an operator rotates adjustment screw1324 in a direction so as to axially displace clevis1322 in a direction, such as a proximal direction. As clevis1322 is axially displaced in a proximal direction, clevis1322 pulls on pinion gear1276 of articulation assembly1270. The pinion gear1276 is engaged with each of rack1274 and rack1272. As pinion gear1276 is axially displaced, in a proximal direction, pinion gear1276 acts on racks1272,1274 to draw racks1272,1274 in a proximal direction. As racks1272,1274 are drawn in a proximal direction, with articulation cables262,264 respectively connected thereto, and with distal ends of articulation cables262,264 fixed or anchored in place, articulation cables262,264 are caused to be tensioned. It is contemplated that a set screw328 (seeFIG.12) may be provided to fix the position of adjustment screw1324 and help to maintain articulation cables262,264 tensioned.
• It is contemplated that over time and/or following a number of uses, as articulation cables262,264 may become slack or stretched, biasing member1325 functions to maintain an acceptable tension on articulation cables262,264, thus reducing a need for an end user of shaft assembly200 to access adjustment screw1324 and re-tension articulation cables262,264. Thus, the spring or biasing member continues to provide a load on the articulation cables.
• As seen inFIGS.50-55,57,58, and63-64, neck assembly230 of shaft assembly200 includes a clutch mechanism1360. Clutch mechanism1360 is operatively connected to second drive cable268 such that rotation of clutch mechanism1360 results in rotation of second drive cable268. The clutch prevents unwanted slippage of the drive cable.
• Clutch mechanism1360 includes a rotatable coupling member1362 rotatably supported in a proximal hub1232aof proximal neck housing1232. SeeFIG.64. Coupling member1362 includes a first end1362aconfigured to receive and mate with first output drive shaft246aof transmission housing212 of shaft assembly200. Coupling member1362 includes a second end1362bhaving a pair of distally extending arms1362c, each defining a pair of camming surfaces.
• Clutch mechanism1360 includes a plunger member1364 rotatably and slidably supported in proximal hub1232aof proximal neck housing1232. Plunger member1364 includes a first end1364ahaving a pair of proximally extending arms1364c, each defining a pair of camming surfaces. The camming surfaces of the plunger member1364 complementing and being in cooperative engagement with the camming surfaces of coupling member1362. Plunger member1364 includes a second end1364bsecured to second drive cable268.
• In aspects of the disclosure, the actuation sled1500 includes a knife blade1502 for transecting the fastened tissue. The knife blade1502 travels slightly behind actuation sled1500 during a stapling procedure to form an incision between the rows of fastener body tissue. As shown inFIG.69, the sled1500 includes a centrally disposed slit1504 for housing the knife blade1502, which is pivotally coupled to the sled1500 via a pin1506. The pin1506 is received within an opening1507 formed in the knife blade1502 (FIG.68). The knife blade1502 includes a blade portion1508 at a distal end and an actuating surface1510 disposed at a proximal end (FIG.67). The knife blade1502 pivots about the pin1506 from a concealed position in which the knife blade1502 is fully submerged within the slit1504, as shown inFIGS.67 and68, and a raised position in which the knife blade1502 is in a deployed upright position extending through the longitudinal slot1512, as shown inFIG.70.
• As the drive beam1514 is driven in the distal direction, the abutment surface1530 of the vertical strut1532 comes in contact with an actuating surface1510 of knife body1502, thereby pivoting the knife blade1502 about the pin1506 and raising the blade portion1508 from the slit1504 and into the longitudinal slot1512, as shown inFIG.70. As the drive beam1514 is continually driven in the distal direction, the abutment surface1530 maintains contact with the knife blade1502, thereby pushing the sled1500 in the distal direction to eject the fasteners and simultaneously dissect tissue with the blade portion1508. The knife blade1502 and the drive beam1514 travel through the knife slot1512 thereby fastening and severing tissue. The drive beam1514 closes the anvil as it is driven in the distal direction and pushes the sled1500 which in turn, ejects the fasteners ahead of the knife blade1502 that is pivoted into the upright position.
• Clutch mechanism1360 includes a coupler1366 axially fixed relative to proximal hub1232aof proximal neck housing1232. Coupler1366 is configured to receive second end1362bof coupling member1362 and first end1364aof plunger member1364 and maintain second end1362bof coupling member1362 and first end1364aof plunger member1364 in operative association with one another. Coupler1366 defines an angled inner-annular surface1366afor mating with an angled outer annular profile of first end1364aof plunger member1364.
• Clutch mechanism1360 includes a biasing member1368 interposed between a surface of proximal hub1232aof proximal neck housing1232 and plunger member1364, tending to urge plunger member1364 toward coupling member1362 and tending to maintain second end1362bof coupling member1362 and first end1364aof plunger member1364 in operative association with one another. The biasing member presses the plunger member against the coupling member so that the camming surfaces of the plunger member in engagement with the camming surfaces of the coupling member.
• In operation, clutch mechanism1360 functions to transmit a rotation from surgical instrument100 to end effector400 to effectuate a rotation of end effector400, as described above. The second drive cable or member268 is rotated by the motor of the instrument housing102. The clutch applies pressure between the coupling member and plunger to prevent slippage. The rotation of the second drive cable268 is transmitted to the end effector, more specifically the rotation hub294 of the end effector, to rotate the end effector.
• AlthoughFIG.1 shows a handle assembly with an electromechanical driver, it is contemplated that the system can include a manually actuated handle assembly in any of the embodiments disclosed herein. Furthermore, the surgical instrument may comprise a stapler, electrosurgical instrument, grasper, or other type of surgical instrument. In any of the embodiments disclosed herein, the articulating shaft assembly may include a neck assembly or a pivot for articulation around a single pivot.
• It will be understood that various modifications may be made to the embodiments disclosed herein. For example, surgical instrument100 and/or cartridge assembly410 need not apply staples but rather may apply two part fasteners as is known in the art. Further, the length of the linear row of staples or fasteners may be modified to meet the requirements of a particular surgical procedure. Thus, the length of the linear row of staples and/or fasteners within a staple cartridge assembly may be varied accordingly. Therefore, the above description should not be construed as limiting, but merely as exemplifications of preferred embodiments. Those skilled in the art will envision other modifications within the scope and spirit of the claims appended thereto.

Claims (21)

1-15. (canceled)

16. A surgical stapling instrument comprising:

a shaft assembly;

a drive beam;

an anvil assembly;

a cartridge assembly comprising:

a cartridge body having a tissue-contacting surface;

a knife slot defined by the cartridge body; and

staples supported within the cartridge body;

an actuation sled;

a knife blade comprising a blade portion, the knife blade coupled to the actuation sled, wherein the knife blade has a concealed position and a raised position, wherein:

at a first distal position of the sled, the knife blade is in the concealed position where the blade portion is positioned below the tissue-contacting surface of the cartridge body; and

at a second distal position of the sled, the knife blade is in the raised position where the blade portion is positioned above the tissue-contacting surface of the cartridge body.

17. The surgical stapling instrument ofclaim 16, wherein the second distal position is positioned distally from the first distal position.

18. The surgical stapling instrument ofclaim 16, wherein the knife blade further comprises an actuating surface.

19. The surgical stapling instrument ofclaim 18, wherein the knife blade transitions from the concealed position to the raised position based on the drive beam contacting the actuating surface.

20. The surgical stapling instrument ofclaim 16, wherein the knife blade is pivotably coupled to the actuation sled.

21. The surgical stapling instrument ofclaim 16, wherein distal advancement of the drive beam causes the actuation sled and the knife blade to be concurrently distally advanced.

22. The surgical stapling instrument ofclaim 17, wherein distal advancement of the drive beam causes the staples to be ejected.

23. The surgical stapling instrument ofclaim 16, wherein the shaft assembly comprises an articulating neck assembly.

24. An end effector for a surgical stapling instrument, the end effector comprising:

an anvil assembly;

a cartridge assembly comprising:

a cartridge body having a tissue-contacting surface;

a knife slot defined by the cartridge body;

an actuation sled;

a knife blade comprising a blade portion, the knife blade coupled to the actuation sled, wherein the knife blade has a concealed position and a raised position, wherein:

at a first distal position of the sled, the knife blade is in the concealed position where the blade portion is positioned below the tissue-contacting surface of the cartridge body; and

at a second distal position of the sled, the knife blade is in the raised position where the blade portion is positioned above the tissue-contacting surface of the cartridge body.

25. The end effector ofclaim 24, wherein the second distal position is positioned distally from the first distal position.

26. The end effector ofclaim 24, wherein the knife blade further comprises an actuating surface.

27. The end effector ofclaim 24, wherein the actuation sled includes a slit, wherein the blade portion is fully submerged within the slit when in the concealed position.

28. The surgical stapling instrument ofclaim 27, wherein the slit is a centrally disposed slit.

29. The end effector ofclaim 24, wherein, when the knife blade is in the raised position, the blade portion extends through the knife slot.

30. A surgical stapling instrument comprising:

a shaft assembly comprising an articulating neck assembly;

a drive member extending through the shaft assembly;

a drive beam, wherein movement of the drive member causes distal movement of the drive beam;

a cartridge assembly comprising:

a cartridge body having a tissue-contacting surface;

a knife slot defined by the cartridge body;

staples; and

staple pushers;

an actuation sled;

a knife blade comprising a blade portion, the knife blade coupled to the actuation sled, wherein the knife blade has a concealed position and a raised position, wherein:

at a first distal position of the sled, the knife blade is in the concealed position where the blade portion is positioned below the tissue-contacting surface of the cartridge body; and

at a second distal position of the sled, the knife blade is in the raised position where the blade portion is positioned above the tissue-contacting surface of the cartridge body.

31. The surgical stapling instrument ofclaim 30, wherein the second distal position is positioned distally from the first distal position.

32. The surgical stapling instrument ofclaim 30, wherein the knife blade further comprises an actuating surface, and the knife blade transitions from the concealed position to the raised position based on the drive beam contacting the actuating surface.

33. The surgical stapling instrument ofclaim 30, wherein the actuation sled includes a slit, wherein the blade portion is at least partially positioned within the slit when the knife blade is in the concealed position.

34. The surgical stapling instrument ofclaim 30, wherein distal advancement of the drive beam causes the actuation sled and the knife blade to be concurrently distally advanced.

35. The surgical stapling instrument ofclaim 31, wherein distal advancement of the drive beam causes the actuation sled to contact the staple pushers to eject the staples.

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